My name is Deborah Egel and I am a registered nurse working for the New York State Office of Alcohol and Substance Abuse Services. I have been with the agency since 1994 and serve as the Public Employees Federation (PEF) Agency Labor/Management chair. I am also a member of the PEF executive board and chair of the statewide nurses committee.

    It was New Years’ Day 1998 when a client came rushing into the nurses’ station telling me to come quickly. As I raced down the stairs wondering what type of medical emergency I would find, I was quickly jolted into reality when I entered the dining room to find complete disarray. Tables were overturned, people were yelling and running, and there was a bloodied client being held back by at least two other clients. Now here I was in the basement, alone, and nothing in nursing school had prepared me for this. After all, nursing school trains people to administer care, not act as bouncers.

    Furthermore, when security was called by the only staff member on duty that day they refused to respond. The only saving grace was that the client afraid of being violated took off and left the unit before the police could respond.

    This incident made me realize how vulnerable I was while at work in the Addiction Treatment Center. Working with an increasingly violent population of chemically addicted, mentally ill, criminal justice clients who are medically compromised puts all workers at risk. There was no program in place to teach the employee how to deal with this type of situation. And try as hard as I may, I could not get anyone to listen.

    OASAS, which operates 13 Addiction treatment centers (ATC’s), provides inpatient addiction services and operates 24 hours/day 7 days a week. Almost half of the clients are involved in the criminal justice system and 50% have an established mental health diagnosis, with one fourth having been hospitalized for mental illness. In addition, clients entering the ATC’s are coming off alcohol and drugs and are in an agitated state, which increases the possibility of violence.

    The changing nature of the clients, which began 3-10 years ago, is attributed to the intervention of drug courts, clients fighting severe levels of deprivation, clients who are younger with more anti-social personality disorders, and facilities which need to be renovated. Also lending to this problem is loss of staff due to downsizing which leads to existing staff becoming overextended. The combined impact of these factors and a lack of security dedicated to the facility leave staff and clients vulnerable.

    However, it wasn’t until I was elected into a union leadership position in 1999 that I was able to make workplace violence prevention a priority and place it on the labor/ management statewide agenda. Due to the nature of my strong relationships with the Director of Labor Relations and the Director of the Addiction Treatment Centers, the agency began to take a serious look at the impact violence was having on our system. We formed a joint labor/ management Task Force and brought in PEF’s Health & Safety Department Director to assist us in developing a program.

    We began this journey by developing a curriculum to help employees deal with and de-escalate violent interactions within the ATC’s. The program entitled Violence Intervention Prevention (VIP) follows the OSHA guidelines and is multifaceted. The program includes policies and procedures for all employees, training, and a critical response team that is trained to address employee concerns when traumatic events occur.

    My experience working with a cooperative management is by its nature very rare. As an Executive Board member for PEF and Chair of the Statewide Nurses Committee I have had the opportunity to speak directly with a wide array of union officials throughout New York State employment. Most of my colleagues report that their employers are not interested in working in true partnership to develop violence prevention programs. I am very fortunate to be able to work with progressive managers who care about the agency and the workforce. But I am concerned about what will happen to our excellent program if and when any of the key players leave or retire. That is why a mandatory standard should be in place so that both the employer and employee will benefit from a safe work environment. Workplace violence programs should not be the rare innovation of progressive managers and union leaders, but a basic requirement for all public worksites. I strongly encourage the Hazard Abatement Board to recommend that the Commissioner of Labor promulgate an enforceable workplace security and safety standard. Our experience shows that these programs work and benefit both labor and management.